Cell therapy in transplantation: A comprehensive review of the current applications of cell therapy in transplant patients with the focus on Tregs, CAR Tregs, and Mesenchymal stem cells

Int Immunopharmacol. 2021 Aug:97:107669. doi: 10.1016/j.intimp.2021.107669. Epub 2021 May 6.

Abstract

Organ transplantation is a practical treatment for patients with end-stage organ failure. Despite the advances in short-term graft survival, long-term graft survival remains the main challenge considering the increased mortality and morbidity associated with chronic rejection and the toxicity of immunosuppressive drugs. Since a novel therapeutic strategy to induce allograft tolerance seems urgent, focusing on developing novel and safe approaches to prolong graft survival is one of the main goals of transplant investigators. Researchers in the field of organ transplantation are interested in suppressing or optimizing the immune responses by focusing on immune cells including mesenchymal stem cells (MSCs), polyclonal regulatory Tcells (Tregs), and antigen-specific Tregs engineered with chimeric antigen receptors (CAR Tregs). We review the mechanistic pathways, phenotypic and functional characteristics of these cells, and their promising application in organ transplantation.

Keywords: Cell therapy; Chimeric antigen receptors; Mesenchymal stem cell; Organ transplantation; Regulatory T cells.

Publication types

  • Review

MeSH terms

  • Allografts / immunology
  • Animals
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / prevention & control*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunotherapy, Adoptive / methods
  • Mesenchymal Stem Cell Transplantation*
  • Organ Transplantation / adverse effects*
  • Receptors, Chimeric Antigen / genetics
  • Receptors, Chimeric Antigen / immunology
  • T-Lymphocytes, Regulatory / immunology
  • T-Lymphocytes, Regulatory / transplantation*
  • Transplantation Tolerance / drug effects
  • Transplantation Tolerance / immunology
  • Transplantation, Autologous / methods
  • Transplantation, Homologous / adverse effects
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Receptors, Chimeric Antigen